Coding & Clinical Documentation Audit

Ensure Compliance And Maximize Your Reimbursements With Us

TriumpHealth offers medical coding audit and clinical documentation audit services to detect bottlenecks, streamline the coding and billing processes. Our auditing services include reviewing coding documentation and fee schedules, analyzing payer reimbursements, identifying the trends and root causes for claim denials, and training the billing staff with process improvements and best practices.

Why Do We Conduct A Medical Coding Audit?

Coding audits provide significant value to healthcare organizations, including:

  • Compliance

Coding audits help ensure compliance with coding guidelines, regulations, and documentation requirements. By conducting regular audits, organizations can identify coding errors, potential fraud or abuse, and areas of non-compliance. This helps mitigate the risk of penalties, audits, and legal issues related to improper coding practices.

  • Revenue Integrity

Accurate and compliant coding is essential for optimal reimbursement. Coding audits help identify under coding or missed opportunities for proper coding, leading to potential revenue loss. By ensuring accurate coding, organizations can maximize their revenue potential and avoid revenue leakage.

  • Documentation Improvement

Coding audits provide insights into documentation deficiencies and gaps that impact coding accuracy. By identifying areas of improvement, organizations can focus on enhancing clinical documentation to support accurate coding, resulting in more complete and specific documentation of patient encounters.

  • Quality Improvement

Coding audits contribute to quality improvement efforts by identifying patterns or trends in coding errors. This helps organizations implement targeted education and training programs for coding staff to improve coding accuracy and consistency. Accurate coding also supports the generation of reliable healthcare data for research, analytics, and quality reporting purposes.

Coding Audit

How Do We Help?

Our highly skilled and experienced staff are certified, and each has a minimum of 5 years of experience in the specialty that you require. We provide assistance to individuals and groups of providers within 57 specialties and 14 facility types. For each of these specialties/facility types, we will request documents such as the following to complete audits:

  • Copies of dictated or handwritten narrative operative/procedure reports
  • Medical records
  • Patient demographics
  • Copies of the claim form for each case or encounter reviewed

TriumpHealth’s expert staff will review medical records to analyze the accuracy of the procedural and diagnostic coding provided. Each review will include a case-by-case coding analysis that will compare your original coding with our experts coding. Areas of focus include incorrect code selection, unbundling issues, missed coding opportunities, code assignment that is not supported by documentation, code order, modifier usage, and documentation deficiencies.

Stay Compliant & Optimize Your Reimbursements With Us!

Our experienced staff provides a useful resource for healthcare organizations looking to achieve greater precision, compliance and revenue. Due to years of experience providing high quality medical coding audit services, TriumpHealth is considered to be one of the best medical coding auditing companies.

To talk to a representative, call 888-747-3836 x0 or email